Dupuytren’s and Burns
Dupuytren’s overlaps in some ways with the local excessive scarring which occur after a burn injury. This report documents the development of progressive Dupuytren’s disease developing in a young man after a hand burn, and reviews the conventional teachings regarding Dupuytren’s: https://www.dupuytrens.org/DupPDFs/2008_Balakrishnan_1422.pdf
Gene Expression in Dupuytren’s
If Dupuytren’s is inherited, what are the genes involved? Difficult question. Every cell in a person’s body has the same genes, but every cell is not the same. The differences between cells are not from different genes, but from differences in gene expression: every cell in the body is like a tiny computer; chromosomes are […]
ß-catenin, Wnt and Dupuytren’s
Ultimately, Dupuytren’s has to do with cell signalling: normal cells are somehow instructed (“signalled”) to become abnormal, and adjacent cells interact with each other in a progression of abnormal changes. One of the many ways that cell signal each other is the Wnt signaling pathway, which involves a series of proteins which trigger cascades of […]
Chondroitin Sulfate, Dermatan Sulfate and Dupuytren’s
Dermatan sulfate is similar to the nutritional supplement chondroitin sulfate, and used to be called chondroitin sulfate. Dermatan sulfate is unusually abundant in fascia affected by Dupuytren’s. Is it the cause or is it the effect of the abnormal biology of Dupuytren’s? Maybe both, as discussed in this review: https://dupuytrens.org/DupPDFs/2007_Kozma.pdf
Open fasciotomy for Dupuytren’s
Patients with Dupuytren’s need two things, mechanical and biological. The former, a simple and safe way to straighten bent fingers, and the latter, a way to prevent disease progression and recurrence. This article reviews pros and cons of a simple mechanical treatment, open fasciotomy, for severe contractures in a group of elderly patients: https://dupuytrens.org/DupPDFs/2007_Jablecki.pdf
Genetic determined biochemistry and Dupuyren’s
The genetic basis of Dupuytren’s is explained by the genetic basis of individual biochemistry and enzymatic variation. Sort of. This fascinating review shows how complicated this can be: https://dupuytrens.org/DupPDFs/2008_Zyluk.pdf
Verapamil, tamoxifen, carnitine – options?
One resource for potential medical treatment of Dupuytren’s is the literature on medicines which work for related conditions such as Peyronie’s. This review examines the rationale and results of propionyl-L-carnitine, acetyl-L-carnitine, verapamil and tamoxifen in treating Peyronie’s disease. Is there a role for these in Dupuytren’s? https://dupuytrens.org/DupPDFs/2002_Cavallini.pdf
Peyronie’s Disease and Dupuytren’s
Dupuytren’s is one manifestation of a systemic fibrotic disorder that can also show up as Ledderhose, frozen shoulder or Peyronie’s disease. Fortunately, the majority of people affected show only one of these conditions, but many have to deal with several or all of these. This summary reviews the condition referred to as Peyronie’s disease: https://dupuytrens.org/DupPDFs/2009_NIDDK.pdf
CMMS therapy for stiffness after fasciectomy for Dupuytren’s
Stiffness is a common problem after fasciectomy, particularly loss of flexion, and can be resistant to stretching exercises or splints. This therapy program, incorporating a combination of casting and active exercises, helped patients regain motion when they had failed conventional hand therapy: https://dupuytrens.org/DupPDFs/2007_Rose.pdf
NICE evaluation of needle aponeurotomy for Dupuytren’s
The source of medical information is critical; objectivity is essential. That’s one of the advantages of the UK’s NHS independent review process. Read their assessment of needle aponeurotomy:https://dupuytrens.org/DupPDFs/2004_NICE.pdf
